Shutterstock/Montebasso. All rights reserved.Suspicions and conspiracy theories regarding vaccines have
been around as long as vaccines themselves. Vaccines are a powerful and
frankly, a scary technology. They are based on placing a version of an often
grave disease in the human body, to build up an immune response. In this sense,
they carry the potential to create illness instead of preventing it. Most
importantly, they are usually administered to a population that is most
vulnerable in a physical, social and cultural sense: children.
Since it is usually states that mandate, distribute and
sometimes manufacture vaccines, distrust in this obscure and potentially risky
technology often maps onto distrust in the state. Anti-vaccination movements in
the United
States and Europe
are good examples of bringing to light the problematic relationships between
citizen and state, as are the recent Ukranian
polio cases during the breakdown
of an administration. In other cases, distrust is toward another state or
political power. This is an issue frequently encountered in global eradication
campaigns, for instance resistance in recent years to polio vaccination in
Northern Nigeria or Pakistan, where some fear that the Sabin vaccine is a
tool of sterilization and part
of a western scheme to crush local populations.
However, such suspicions of vaccine are not exclusive to
current campaigns, nor are conspiracy theories like the above restricted to the
Global South. The development of live polo vaccines, like the Sabin vaccine,
which has been the major tool of global polio eradication for many decades, was
engulfed in very similar concerns and suspicions. Part of these suspicions was rooted
in the novelty of the vaccine and the scientific uncertainty surrounding the
disease and its prevention. Another component of these conspiracy theories must
be attributed to the unfolding Cold War.
A new vaccine
Among vaccines, live ones are especially tricky: unlike unactivated
vaccine, in which the virus itself is killed, they contain a weakened, but live
virus that is potent enough to elicit an immune response, but not strong enough
to cause illness. The major concern regarding the live poliovirus vaccines has
been their potential to turn virulent and cause paralysis – or even epidemics. This
concern was very much shared among the scientific community: countless articles
and international conferences debated the safety of the vaccines as virologists
moved from the lab to field testing in the late 1950s.
The issue of vaccine safety has been a constant concern since
the introduction of live polio vaccines. In the course of the 65 years and more
since the live vaccine developed by Albert Sabin begun to be used worldwide,
virologists have determined some of the risks of vaccine-associated
paralytic polio (VAPP) and vaccine-derived polioviruses (VDPVs) and current
eradication campaigns have integrated these possibilities. However, other suspicions
about the research methods and trial procedures of the 1950s vaccine
development era have surfaced recently, bringing to light distrust in the
scientific community as an establishment.
The most well-known conspiracy theory in polio vaccination
regards Koprowski’s trial in the Belgian Congo as put forth by journalist
Edward Hooper in his book The
River, published in 2000. Hooper argued that during the production process
Koprowski’s vaccine was contaminated with SIV (Simian Immunodeficiency Virus)
and became the ultimate cause for the origins of HIV. The HIV origin theory
emerged in the wake of the shock of a global epidemic of an unknown virus and
speaks most of all to current issues of power within scientific and academic
communities. The book and Hooper’s argument gained worldwide publicity and the
allegations were not taken lightly. The Royal Society launched an investigation
and independent laboratories examined frozen samples,
concluding that Hooper’s theory lacked sufficient evidence. Hooper claims
that the wrong samples have been chosen for examination and firmly upholds his
theory.
Cold War suspicions
Suspicions about the development and introduction of live
polio vaccines in the 1950s have not only appeared retrospectively. The
development of what became the tool of the current global polio eradication
campaign was beset by distrust in scientific achievements and worries about
intentional harm. Russian scientists feared that the Sabin vaccine and its
trial in the Soviet Union was part of an American plot to sterilize or kill
Soviet children by the millions, while American virologists were suspicious of
the Russian claims regarding vaccine safety and efficacy based on field trials.
These concerns might ring familiar today, but they were the product of a
particular political and social context and existed alongside intensive
co-operation that worked against the same fears.
In order to understand the suspicions and conspiracy
theories that peppered live polio vaccine development and shaped scientific
discourse and decision-making, we need to take a look at the geopolitical
background and the often conflicting international co-operation in the history
of polio.
In the face of rising epidemics, polio became to be
considered as a “world problem”, as termed by Anthony Payne, head of the WHO’s
Communicable Diseases Division. More and more countries experienced more and
more severe polio outbreaks and by the 1950s it became a common concern that
arched over political ideologies and borders. In countries that suffered grave
demographic shocks in World War II, the peak in epidemics that left children
paralysed by the thousands coincided with pro-natalist policies and
reconstruction programs that magnified the consequences of polio’s threat.
The growing global concern over polio provided space for
international co-operation on a seemingly neutral ground. Virologists working
on live vaccines participated in an intensive exchange of knowledge, data and
specimens that reached over the iron curtain and crossed continents. Scientists
met regularly at international conferences, lab visits and study trips. In the
1950s, Albert Sabin, Hilary Koprowski and Herald Cox tested three different
vaccines in field trials spanning four continents, from Singapore through
Poland to Mexico.
The East
At the same time these co-operations were often engulfed in
mutual mistrust and the suspicion of hidden political agendas. A Hungarian
physician’s experience in the Soviet Union shows the extent to which suspicions
pervaded scientific work and public health policies. Domokos Boda,
paediatrician and key player in polio prevention and treatment in Hungary, was
part of the delegation sent to the Soviet Union in 1959. The task at hand was
to give expert advice on whether to implement the Sabin vaccine in Hungary,
which was at that point tested in mass vaccination trials across the USSR. The
members of the delegation visited labs engaged in both Salk and Sabin vaccine
production. According to Boda, one of the Russian virologists there pulled them
aside and told them not to trust the Sabin vaccine. His argument was the
following: the Americans conducted field trials on home ground for the Salk
vaccine, but the Sabin vaccine did not go through the same process. It was only
being tested abroad, on Russian soil. The Salk vaccine therefore is safe, but
the Sabin vaccine was designed as part of a plan to undercut the Russian
population.
The Hungarians were aghast. What should they do? Many
Hungarian virologists had long-standing professional relationships with Sabin
and were overall convinced by the results. They were to include all their
experiences in the report to the government, but they knew that if they spoke
of this theory, the Hungarian leadership would not proceed with the
implementation. They chose to keep quiet and went on to recommend the Sabin vaccine,
and Hungary became one of the first countries in the world to use the new
vaccine in a nation-wide mass vaccination campaign.
The Hungarian virologists’ concerns were well founded. By
the end of the 1950s the choice of vaccine in Hungary was a high stakes one.
Despite mass campaigns with the Salk vaccine, an unexpected and severe outbreak
shook the country. The state needed to act fast: after the bloody 1956
revolution, the government needed to prove that it was capable of solving
crises. It could not risk any signs of weakness. Unsurprisingly, the Kádár government, whose members had assisted in
crushing the revolution were not regarded as highly trustworthy. Rumors of the
time still circulate to this day to the effect that the government cut Salk
vaccine doses by half, and that it was this disregard for the health of
children that led to the new outbreak.
The West
Suspicions
and conspiracy theories were abundant on the western side of the Iron Curtain
as well. Many American scientists distrusted the Russian field trials and were
reluctant to accept the data on efficacy and safety as produced by the Soviet
system. Just like some of their Russian colleagues, albeit for different
reasons, they did not trust the Sabin vaccine, precisely because it was tested
on Russian soil. Their Russian colleagues responded with a sentiment similar to
that voiced in Sting’s Cold War hit decades later: the Russians love their
children too. Why would they put their own in harm’s way?
In order to
resolve the situation, the WHO emerged as a neutral agency to determine if the
Sabin trials were scientifically sound. On American request, Dorothy Horstmann,
renowned virologist from Yale University visited the Soviet Union to investigate
the field trials on site and to investigate the validity of the data.
Horstmann’s positive report to the WHO was a game-changer for the western world
and for the acceptance of the Sabin vaccine as a polio prevention tool on a
global scale. Interestingly, the arguments Horstmann lined up to back her
claims fed from the same stereotypes of the Soviet state system as those on
which American fears were based. It was exactly because it was the Soviet Union
that one should trust the trials, she argued. They had the military-like public
health organization system, the compliant population and total control that
were all ideal for such a trial and served as guarantees for conducting the
mass vaccination efficiently and reliably. Three years after the Soviet Union,
Czechoslovakia and Hungary introduced the Sabin vaccine into their national
vaccination program, the United States followed suit. (You can read more on the
Hungarian story and Horstmann’s visit to the USSR here).
Easily dismissed by some as fictional and outright
entertaining, or considered the ultimate truth by others, these suspicions and
conspiracy theories, whether voiced by the target population, the authorities
or the scientific community have very real consequences. Some have laid the
foundations for new outbreaks of forgotten diseases, others served as a
springboard for an international organization to find a long-lasting role in
its formative years.
From a historical – and contemporary – perspective, it is
precisely because of the palpable effects of the lack or presence of confidence
in vaccines, and because of the high stakes involved (both for the health and safety of individuals and society) –
that these suspicions and conspiracy theories warrant a need for a closer
analysis.
Trust is key in any public health intervention, whether
local or global, and examining suspicions, such as those surrounding polio
vaccines, reveals much about how that trust is produced and reasons why it
might be lacking. The relationships and expectations between state and
citizens, scientific communities and the public, and political or ideological
adversaries, is above all what we need to understand.